As many as 220,000 uninsured children in California will be excluded from health care reform programs because of their or their parents' immigration status, according to an analysis released yesterday.
When fully implemented in 2014, the Patient Protection and Affordable Care Act will expand health insurance to millions of uninsured Californians. But about 20 percent of the state's 1 million uninsured children will be left out because they or their parents are illegal immigrants, researchers at the UCLA Center for Health Policy Research said.
"The Affordable Care Act doesn't really go to covering all kids," said Shana Alex Lavarreda, director of health insurance studies at the center and an author of the report. "It doesn't get to that 100 percent coverage mark that we've been trying to get to."
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The findings, funded in part by The California Endowment, a financial supporter of California Watch, are based on data from the 2007 California Health Interview Survey. The survey counts respondents who were non-citizens without green cards as undocumented immigrants.
Since 2007, the number of uninsured Californians has climbed. At the same time, immigration has slowed. How many children would be left out of health care reform programs today is unclear, but it's likely "the magnitude is about the same," Lavarreda said.
Researchers estimate that 170,000 children will be barred from enrolling in Medi-Cal or purchasing private insurance in the California Health Benefit Exchange because they are illegal immigrants. Federal law prohibits the use of federal funds to provide health care services for illegal immigrants.
An additional 10,000 children are legal immigrants and have household incomes qualifying them for Medi-Cal, but they have been in the U.S. fewer than five years, making them ineligible for the federally funded program.
While California has historically used state funds to cover these immigrants in Medi-Cal, state budget cuts put their coverage at risk. If the state cuts coverage for these recent immigrants, an additional 98,000 children currently enrolled in Medi-Cal will be dropped. They could, however, purchase insurance through the exchange when it opens.
Health care reform could indirectly leave out some uninsured children as well, researchers found. Their analysis estimates that 40,000 uninsured children could potentially be excluded from programs because of their parents' citizenship status. Parents who are not citizens and do not have green cards do not qualify for the programs, but they may not know their citizen children do.
Three out of four citizen children with undocumented parents are covered by public programs – a sign that parents are able to navigate the system, Lavarreda said. But, she said, "the state has a job ahead of it in making sure that everybody, including people of all immigration statuses, know exactly what they might be eligible for and how to access services."
Some parents may fear jeopardizing their own immigration status by enrolling their children in public programs, said Doreena Wong, project director of the Asian Pacific American Legal Center's Health Access Project.
"There is this pervasive fear among the undocumented," she said. "There's this fear that if you take any kind of public benefits, including Medi-Cal or Healthy Families, that when you try to adjust your status and get your green card, you'll be denied."
That's a widespread misconception, Wong said. Parents can apply for their children to enroll in Medi-Cal without having to divulge their own immigration status, she said.